288 research outputs found
"C'est le palu qui me fatigue" : une étude en l'anthropologie de la santé sur les conceptions et les pratiques locales face au paludisme à Abidjan, Côte d'Ivoire
Malaria is the most frequent reason for consultations in Côte d'Ivoire's health centres. In the year 2004, 57% of all medical cases were attributed to malaria. The resulting social and economic burden for the local population is considerable.
This medical anthropology thesis aims to better understand what malaria means for the inhabitants of the city of Abidjan and how they deal with it. More specifically, the thesis pursues the following objectives: (1) to examine the experiences, meanings and practices in everyday life of adults concerned with the illness, (2) to compare the distribution of these topics in an urben squatter settlement and a middle-class area, (3) to study what meanings and practices constitute for an episode and (4) how they have changed over time.
The study is located in Abidjan, the economic capital of Côte d'Ivoire, and more precisely in the municipality of Yopougon. The rapid urbanisation of the area began in the 1970s, and today Yopougon is home to already over one million inhabitants. The development of the urban infrastructure could not keep up with these fast population changes. In the context of the research project NCCR North-South, this study was carried out in a squatter settlement, a quartier précaire, and a neighbouring middle-class area.
The study combines classical anthropological methods and methods of cultural epidemiology. The ethnographic data were collected between 2003 and 2005 during a total of 13 months of field work. Ethnography included interviews, formal and informal discussions, literature review and participant observation. A semi-structured interview catalog (EMIC interview) based on cultural epidemiology was developed and used in interviews with 160 adults. In each area, 80 men and women were randomly selected, all of whom had experienced a self-diagnosed malaria episode within the last fortnight.
The results illustrate that the biomedical term for malaria found its way into the local illness terminology. The abbreviation "palu" for the French term "paludisme" (malaria) is frequently used in everyday interaction. However, a more thorough analysis shows that even when the same word is used in the professional and the local context, the meanings only corerspond to a certain degree. There is an overlap between the biomedical and the local classification. The local use of the term essentially covers a much wider range of meanings. experiences and treatment options than the original biomedical term. Fever as a symptom does not have an outstanding position, but represents only one of numerous signs.
The concept of malaria was appropriated in a process during which an expansion of its meanings took place. The theoretical framework of appropriation, understood as an active process of interaction that makes something one's own, is most useful to trace this developent and its results. For this urban population, the causes of palu are not limited to the parasite transferred by the mosquito, but they refer in particular to people's living conditions. Bad housing conditions shaped by environmental risks due to an insufficient infrastructure or difficult working conditions are experienced as causes of the illness episode. Furthermore, food that does not correspond to the local ideals can lead to palu. The people affected by palu express thus through palu a malaise that is due to a general vulnerability anchored in this urban field. In a more abstract sense, palu becomes an embodied metaphor for the adversities that people experience in their everyday life.
During the process of appropriation, not only the meanings but also the possible treatment options were expanded. The health system for Abidjan offers a great diversity of treatment options ranging from university hospitals to Chinese drug sellers offering their produts at the roadside. For the treatment of palu, pharmaceuticals from official as well as illegal pharmacies and local herbal medicines are the most commonly used products. Self-treatment plays thereby an important role. Local herbs and pharmaceuticals were used by 63% and 52% of the study participants respectively in order to fight their episode. Health services were visited mainly in combination with self-treatment. However, the study illustrates that overall only 28% and 42% received appropriate malaria treatment within 24 and 48 hours, respectively, of the onset of symptoms. Additionally, results show that inhabitants from the poor area had significantly less access to timely and appropriate malaria treatment compated to inhabitants of the middle-class area. Although spatial proximity to high-quality treatment exists in the urban context, access to it is not ensured. On the one hand, this can be blamed on factors, which concern the quality of care. The sold drugs do not correspond to the current treatment guideline and many private facilities are not equipped with the qualified personnel and material to diagnose and treat malaria appropriately. Above all, the moment of interaction between private health providers and their clients is not taken advantage of by the providers to advise the customers regarding adequate treatment.
On the other hand, the study shows how social context and cultural concepts of illness may be considered in explaining timely and appropriate treatment for malaria. The expansion of the malaria concept and its relative treatment possibilities through appropriation incorporate the risk of over- and mistreatment. The complex interaction of these different factors therefore affects access to a successful cure.
The restults illustrate that the improvement of access to effective malaria treatment must make it easier for patients to select the appropriate treatment from the broad urben offer. On the one hand improvements of the quality of the care are necessary. Training of health staff and, in addition, a clear marking of appropriate medicines is central. The introduction of the new ACT-antimalarials should be limited to products that are clearly identifiable as recommended therapy. This improvement will allow making an informed choice for home management. The introduction of new drugs must be accompanied by close monitoring of information, education and communication campaigns. Thus, the appropriation process of these products is to be controlled in order to be able to limit an extension of their meanings as much as possible.
On the other hand, multi-layered interventions are necessary to reduce the general vulnerability of city dwellers with regards to palu. Improved work and housing conditions as well as a reduction of the urban environmental risks are indispensable
Social and cultural aspects of 'malaria' and its control in central Côte d'Ivoire
Background. A sound local understanding of preventive measures and health-seeking behaviour is important for the effective control of malaria. The purpose of this study was to assess the knowledge, attitudes, practices and beliefs of 'malaria' and its control in two rural communities of central Côte d'Ivoire, and to examine associations between 'malaria' and the households' socioeconomic status. Methods. A cross-sectional household survey was carried out, using a combination of qualitative and quantitative methods. People's socioeconomic status was estimated, employing a household asset-based approach. Results. Malaria was identified as djèkouadjo, the local folk name of the disease. Although people were aware of malaria-related symptoms and their association with mosquitoes, folk perceptions were common. In terms of treatment, a wide array of modern and traditional remedies was employed, often in combination. Individuals with a sound knowledge of the causes and symptoms of malaria continued to use traditional treatments and only a few people sleep under bed nets, whereas folk beliefs did not necessarily translate into refusal of modern treatments. Perceived causes of malaria were linked to the household's socioeconomic status with wealthier individuals reporting mosquitoes more frequently than poorer households. Bed nets were more frequently used in wealthier social strata, whereas other protective measures - perceived to be cheaper - were more prominent among the poorest. Conclusion. Equitable access to resources at household, community and health system levels are essential in order to enable community members to prevent and treat malaria. There is a need for community-based approaches that match health care services with poor people's needs and resources
Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires
The production of tt‾ , W+bb‾ and W+cc‾ is studied in the forward region of proton–proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fb−1 . The W bosons are reconstructed in the decays W→ℓν , where ℓ denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of , and is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 0.02 \mbox{fb}^{-1}. The bosons are reconstructed in the decays , where denotes muon or electron, while the and quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions
A study of CP violation in B-+/- -> DK +/- and B-+/- -> D pi(+/-) decays with D -> (KSK +/-)-K-0 pi(-/+) final states
A first study of CP violation in the decay modes and , where labels a or meson and labels a or meson, is performed. The analysis uses the LHCb data set collected in collisions, corresponding to an integrated luminosity of 3 fb. The analysis is sensitive to the CP-violating CKM phase through seven observables: one charge asymmetry in each of the four modes and three ratios of the charge-integrated yields. The results are consistent with measurements of using other decay modes
Study of the rare B-s(0) and B-0 decays into the pi(+) pi(-) mu(+) mu(-) final state
A search for the rare decays and is performed in a data set corresponding to an integrated luminosity of 3.0 fb collected by the LHCb detector in proton-proton collisions at centre-of-mass energies of 7 and 8 TeV. Decay candidates with pion pairs that have invariant mass in the range 0.5-1.3 GeV/ and with muon pairs that do not originate from a resonance are considered. The first observation of the decay and the first evidence of the decay are obtained and the branching fractions are measured to be and , where the third uncertainty is due to the branching fraction of the decay , used as a normalisation.A search for the rare decays Bs0→π+π−μ+μ− and B0→π+π−μ+μ− is performed in a data set corresponding to an integrated luminosity of 3.0 fb−1 collected by the LHCb detector in proton–proton collisions at centre-of-mass energies of 7 and 8 TeV . Decay candidates with pion pairs that have invariant mass in the range 0.5–1.3 GeV/c2 and with muon pairs that do not originate from a resonance are considered. The first observation of the decay Bs0→π+π−μ+μ− and the first evidence of the decay B0→π+π−μ+μ− are obtained and the branching fractions, restricted to the dipion-mass range considered, are measured to be B(Bs0→π+π−μ+μ−)=(8.6±1.5 (stat)±0.7 (syst)±0.7(norm))×10−8 and B(B0→π+π−μ+μ−)=(2.11±0.51(stat)±0.15(syst)±0.16(norm))×10−8 , where the third uncertainty is due to the branching fraction of the decay B0→J/ψ(→μ+μ−)K⁎(892)0(→K+π−) , used as a normalisation.A search for the rare decays Bs0→π+π−μ+μ− and B0→π+π−μ+μ− is performed in a data set corresponding to an integrated luminosity of 3.0 fb−1 collected by the LHCb detector in proton–proton collisions at centre-of-mass energies of 7 and 8 TeV . Decay candidates with pion pairs that have invariant mass in the range 0.5–1.3 GeV/c2 and with muon pairs that do not originate from a resonance are considered. The first observation of the decay Bs0→π+π−μ+μ− and the first evidence of the decay B0→π+π−μ+μ− are obtained and the branching fractions, restricted to the dipion-mass range considered, are measured to be B(Bs0→π+π−μ+μ−)=(8.6±1.5 (stat)±0.7 (syst)±0.7(norm))×10−8 and B(B0→π+π−μ+μ−)=(2.11±0.51(stat)±0.15(syst)±0.16(norm))×10−8 , where the third uncertainty is due to the branching fraction of the decay B0→J/ψ(→μ+μ−)K⁎(892)0(→K+π−) , used as a normalisation.A search for the rare decays and is performed in a data set corresponding to an integrated luminosity of 3.0 fb collected by the LHCb detector in proton-proton collisions at centre-of-mass energies of 7 and 8 TeV. Decay candidates with pion pairs that have invariant mass in the range 0.5-1.3 GeV/ and with muon pairs that do not originate from a resonance are considered. The first observation of the decay and the first evidence of the decay are obtained and the branching fractions, restricted to the dipion-mass range considered, are measured to be and , where the third uncertainty is due to the branching fraction of the decay , used as a normalisation
Observation of the B0 → ρ0ρ0 decay from an amplitude analysis of B0 → (π+π−)(π+π−) decays
Proton–proton collision data recorded in 2011 and 2012 by the LHCb experiment, corresponding to an integrated luminosity of 3.0 fb−1 , are analysed to search for the charmless B0→ρ0ρ0 decay. More than 600 B0→(π+π−)(π+π−) signal decays are selected and used to perform an amplitude analysis, under the assumption of no CP violation in the decay, from which the B0→ρ0ρ0 decay is observed for the first time with 7.1 standard deviations significance. The fraction of B0→ρ0ρ0 decays yielding a longitudinally polarised final state is measured to be fL=0.745−0.058+0.048(stat)±0.034(syst) . The B0→ρ0ρ0 branching fraction, using the B0→ϕK⁎(892)0 decay as reference, is also reported as B(B0→ρ0ρ0)=(0.94±0.17(stat)±0.09(syst)±0.06(BF))×10−6
Measurement of the (eta c)(1S) production cross-section in proton-proton collisions via the decay (eta c)(1S) -> p(p)over-bar
The production of the state in proton-proton collisions is probed via its decay to the final state with the LHCb detector, in the rapidity range GeV/c. The cross-section for prompt production of mesons relative to the prompt cross-section is measured, for the first time, to be at a centre-of-mass energy TeV using data corresponding to an integrated luminosity of 0.7 fb, and at TeV using 2.0 fb. The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the and decays to the final state. In addition, the inclusive branching fraction of -hadron decays into mesons is measured, for the first time, to be , where the third uncertainty includes also the uncertainty on the inclusive branching fraction from -hadron decays. The difference between the and meson masses is determined to be MeV/c.The production of the state in proton-proton collisions is probed via its decay to the final state with the LHCb detector, in the rapidity range . The cross-section for prompt production of mesons relative to the prompt cross-section is measured, for the first time, to be at a centre-of-mass energy using data corresponding to an integrated luminosity of 0.7 fb , and at using 2.0 fb . The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the and decays to the final state. In addition, the inclusive branching fraction of -hadron decays into mesons is measured, for the first time, to be , where the third uncertainty includes also the uncertainty on the inclusive branching fraction from -hadron decays. The difference between the and meson masses is determined to be .The production of the state in proton-proton collisions is probed via its decay to the final state with the LHCb detector, in the rapidity range GeV/c. The cross-section for prompt production of mesons relative to the prompt cross-section is measured, for the first time, to be at a centre-of-mass energy TeV using data corresponding to an integrated luminosity of 0.7 fb, and at TeV using 2.0 fb. The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the and decays to the final state. In addition, the inclusive branching fraction of -hadron decays into mesons is measured, for the first time, to be , where the third uncertainty includes also the uncertainty on the inclusive branching fraction from -hadron decays. The difference between the and meson masses is determined to be MeV/c
Angular analysis of the B-0 -> K*(0) e(+) e(-) decay in the low-q(2) region
An angular analysis of the decay is performed using a data sample, corresponding to an integrated luminosity of 3.0 {\mbox{fb}^{-1}}, collected by the LHCb experiment in collisions at centre-of-mass energies of 7 and 8 TeV during 2011 and 2012. For the first time several observables are measured in the dielectron mass squared () interval between 0.002 and 1.120. The angular observables and which are related to the polarisation and to the lepton forward-backward asymmetry, are measured to be and , where the first uncertainty is statistical and the second systematic. The angular observables and which are sensitive to the photon polarisation in this range, are found to be and . The results are consistent with Standard Model predictions.An angular analysis of the B → K^{*}^{0} e e decay is performed using a data sample, corresponding to an integrated luminosity of 3.0 fb, collected by the LHCb experiment in pp collisions at centre-of-mass energies of 7 and 8 TeV during 2011 and 2012. For the first time several observables are measured in the dielectron mass squared (q) interval between 0.002 and 1.120 GeV /c. The angular observables F and A which are related to the K^{*}^{0} polarisation and to the lepton forward-backward asymmetry, are measured to be F = 0.16 ± 0.06 ± 0.03 and A = 0.10 ± 0.18 ± 0.05, where the first uncertainty is statistical and the second systematic. The angular observables A and A which are sensitive to the photon polarisation in this q range, are found to be A = − 0.23 ± 0.23 ± 0.05 and A = 0.14 ± 0.22 ± 0.05. The results are consistent with Standard Model predictions.An angular analysis of the decay is performed using a data sample, corresponding to an integrated luminosity of 3.0 {\mbox{fb}^{-1}}, collected by the LHCb experiment in collisions at centre-of-mass energies of 7 and 8 TeV during 2011 and 2012. For the first time several observables are measured in the dielectron mass squared () interval between 0.002 and 1.120. The angular observables and which are related to the polarisation and to the lepton forward-backward asymmetry, are measured to be and , where the first uncertainty is statistical and the second systematic. The angular observables and which are sensitive to the photon polarisation in this range, are found to be and . The results are consistent with Standard Model predictions
Search for the lepton flavour violating decay tau(-) -> mu(-)mu(+)mu(-)
A search for the lepton flavour violating decay is performed with the LHCb experiment. The data sample corresponds to an integrated luminosity of 1.0 fb of proton-proton collisions at a centre-of-mass energy of 7 TeV and 2.0 fb at 8 TeV. No evidence is found for a signal, and a limit is set at 90% confidence level on the branching fraction, .A search for the lepton flavour violating decay τ → μ μ μ is performed with the LHCb experiment. The data sample corresponds to an integrated luminosity of 1.0 fb of proton-proton collisions at a centre-of-mass energy of 7 TeV and 2.0 fb at 8 TeV. No evidence is found for a signal, and a limit is set at 90% confidence level on the branching fraction, .A search for the lepton flavour violating decay is performed with the LHCb experiment. The data sample corresponds to an integrated luminosity of of proton-proton collisions at a centre-of-mass energy of and at . No evidence is found for a signal, and a limit is set at confidence level on the branching fraction,
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